Incidence of cancer and cancer related mortality in opiate dependent patients treated with methadone, buprenorphine or implant naltrexone as compared with non-opiate using controls

Erin Kelty, Timothy Dobbins, Gary Hulse

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)

    Abstract

    Background: Cancer has been identified as a common cause of mortality in opiate dependent patients. Aim: To examine
    and compare the incidence of cancer and cancer mortality in opiate dependent patients treated with methadone, buprenorphine
    or implant naltrexone to a cohort of controls taken from the general population. Methods: The study was a retrospective
    longitudinal follow up using routinely collected cancer and mortality data. Participants included opiate dependent
    patients treated for the first time with methadone (n=2,227), buprenorphine (n=1,954) or implant naltrexone (n=958)
    between 2001 and 2010 in Western Australia (WA) and a sex and age matched cohort of controls selected from the WA
    electoral roll. Incidence of cancer and cancer related mortality in the four groups were analyzed using Cox proportional
    hazard regression. Results: Rates of cancer in opiate patients treated with methadone (HR:0.81, CI:0.49-1.34), buprenorphine
    (HR:0.74, CI:0.41-1.33) and naltrexone (HR:0.65, CI:0.28–1.50) participants were not significantly different to the
    control cohort. Rates of respiratory cancer were elevated in patients initially treated with methadone (HR:7.53, CI:1.46–
    38.93) and naltrexone (HR:7.65, CI:1.07–54.48). Mortality rates in patients diagnosed with cancer were significantly
    elevated in patients treated in methadone (HR:3.19, CI:1.07–9.53), while both buprenorphine (HR:3.07, CI:0.78–12.15)
    and naltrexone (HR:3.73, CI:0.77–18.02) were not dissimilar to the controls. Conclusions: While rates of cancer were not
    significantly different to the control, poor survival may attribute to high rates of cancer related mortality.
    Original languageEnglish
    Pages (from-to)65-72
    Number of pages8
    JournalHeroin Addiction and Related Clinical Problems
    Volume19
    Issue number3
    Publication statusPublished - 1 Jun 2017

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